Take A Number (Why “First come, first served” shouldn’t last)

So you think the ‘ol “First Come, First Served” mantra should be a staple of society? Maybe you’re right. But next time you’re rushed to the ER, gripping your chest and struggling to breathe, remember that dude with the broken pinkie got there first.

A young teen walks calmly across the emergency room parking lot with his mother by his side. He holds his left arm gingerly across his abdomen with his right—the arm, obviously broken. Just before entering the front doors, tires screech behind them. Shouts ring out, “Go you two. Go!” Another mother and son jump out of the car, the youngster holding his arm in the exact same fashion. They push past the calm duo, “Out of the way, his arm’s broke!” The husband and father of this frantic pair had run three red lights, nearly hit two pedestrians in crosswalks, and caused one accident while speeding and aggressively changing lanes without use of a turn signal. But they got to the ER quick. All things being equal as far as the medical diagnosis is concerned, which child deserves to be the first to get medical attention?

“First come, first served” is not always the best policy.

We’ve all been to that bar on a crowed Saturday night. You remember bars during BC times, right? Before COVID. You just need one more chair to get your whole party seated, so you go to take one of the three unused chairs from the next table with only two dudes sitting there. But they say the seats are saved for their friends who are on their way. You want to grab one of the chairs and say, “Too bad buddy—First come, first served!” But you don’t. Why? Because our culture has mandated saving seats to be an acceptable practice. As long as part of the party is there, they get to lift their legs and mark whatever area they want, like some animalistic form of reservation.

Should this be allowed, though? Some will argue you shouldn’t monopolize a seat— especially if the establishment is busy—thus potentially robbing the bar of profits and the wait staff of tips every moment a seat is empty. A point firmly in favor of “First come, first served.” These folks further believe the only reason a seat should be saved is if a customer is already there and has to vacate the seat for a short period of time: to hit up the bartender for a drink, hit the head, or hit on an intoxicated co-ed.

Then again, getting somewhere early and saving seats is little more than a form of short-term reservation. All manner of places encourage call-ahead reservations, sometimes months, or even years in advance. If we do away with these in-person, short-term reservations, how can we realistically maintain the concept of reservations at any level? How many of you have walked into a nearly empty restaurant, planning on an early dinner, only to be told you couldn’t be seated because all the tables were reserved for patrons that wouldn’t begin to arrive for another 30 minutes? It’s ridiculous, but we’ve all been there. Still, we’d never seek to completely rid the world of reservations. A point solidly opposing the “First come, first served” mantra.

Staying with the restaurant topic, ever go to a “Seat-yourself” restaurant and have a staff member yell to you, “Go ahead, sit wherever you’d like”? It’s understood they mean any seat that doesn’t already have an ass occupying it. Taken literally, though, the employee is giving you carte blanche to give the old heave-ho to a fellow diner mid-meal. And, by extension, all patrons that arrive after you will be granted that same permission to commandeer your booth and perhaps what’s left of your fries. This would not be a good thing.

So, obviously, “First come, first served” is sometimes the best policy.

But that’s not the case in the world of medicine. The medical landscape is perhaps the environment where your arrival time means the least in respect to when you’re seen. Medical professionals are trained in triage. Prioritization was important during wars of the past, and remains so today in the ER, or in the field during natural disasters, terrorist attacks, etc. A triage nurse wouldn’t allow either of those kids with the arm fractures to get medical attention before a fella rushed in by ambulance with a bullet in his abdomen. It doesn’t matter which one of them got through the metal detectors first. The mantra in the ER is more akin to “Worst come, first served.”

BTW, if you want to cut the line at the ER, just tell them you can’t breathe.

As I write this, the U.S. has just over 14% of its population fully vaccinated for COVID. That doesn’t sound like a huge accomplishment, but when you figure our staggering population is somewhere in the neighborhood of 330 million people, that equates to a lots of shots in arms. So many, in fact, that people are finding themselves unable to make an appointment for a vaccine.

Ohio just recently opened up eligibility to everyone ≥16 years of age. Imagine if the vaccine was initially available to everyone on a “First come, first served” basis, rather than just those 80+. We’d of had the ER parking lot scenario to the n^th degree. High school football linemen blocking 80-year-old ladies as their teammates rush to the pharmacy. Government officials using their status to get a dose the first day they were available. Could you imagine either of those scenarios?

So, you still think the ‘ol “First Come, First Served” mantra should be a staple of society? I don’t want to stand in line at the BMV, the deli, or the dry cleaners. But at the same time, I do want to maintain my place in the queue. What am I to do? I’ll take the next numbered ticket from the aptly named “Take A Number” dispenser. Not only does that tiny, numbered ticket guarantee my deserved spot in line, but I feel like I’m 20 years younger. It’s been that long since I’ve seen one of those dispensers outside of a Seinfeld rerun. So, I guess, yeah, come to think of it . . . You’re Probably Right.